title: Deep vein thrombosis after arthroscopic anterior cruciate ligament reconstruction: a prospective cohort study of 100 patients.
abstract: OBJECTIVE
  To establish the incidence of venous thromboembolic complications as detected by bilateral complete compression ultrasonography (CCUS) after arthroscopic anterior cruciate ligament (ACL) reconstruction without thromboprophylaxis.
  
  
  METHODS
  We performed a prospective cohort study to establish the incidence of venous thromboembolic complications after arthroscopic ACL reconstruction, as detected by bilateral CCUS at 14 days (range, 11 to 17 days) postoperatively. One hundred consecutive patients underwent bilateral extended ultrasonography.
  
  
  RESULTS
  One hundred predominantly European patients with a mean age of 30 ± 10 years and mean body mass index of 25 ± 4 underwent ACL reconstruction with a mean operative duration of 68 ± 23 minutes and a tourniquet time of 76 ± 23 minutes. In 84% of patients an autologous hamstring graft was used, in 14% a bone-patellar tendon-bone graft was used, and 2 patients received an allograft. Of 100 patients, 9 (incidence, 9%; 95% confidence interval, 4.2 to 16.4) showed asymptomatic proximal or distal deep vein thrombosis on CCUS, of whom 4 (incidence, 4%; 95% confidence interval, 1.1 to 9.9) were symptomatic. A nonfatal pulmonary embolus developed in 1 patient during the 8-week follow-up period.
  
  
  CONCLUSIONS
  This study shows that the incidence of venous thromboembolism after arthroscopic ACL reconstruction is relatively high; a 9% incidence of asymptomatic proximal or distal deep vein thrombosis was found, whereas 4% of patients were symptomatic. Further research is recommended to assess the need for thromboprophylaxis in patients undergoing ACL reconstruction, especially when risk factors are present.
  
  
  METHODS
  Level IV, case series.
authors.affiliation: Department of Orthopaedic Surgery, Isala Klinieken, Zwolle, The Netherlands. mcstruijk@gmail.com
authors.forename: Marieke C
authors.initials: MC
authors.lastname: Struijk-Mulder
authors.forename: Harmen B
authors.initials: HB
authors.lastname: Ettema
authors.forename: Cees C P M
authors.initials: CC
authors.lastname: Verheyen
authors.forename: Harry R
authors.initials: HR
authors.lastname: Büller
mesh_terms: D000328:Adult; D000367:Age Factors; D016118:Anterior Cruciate Ligament / Q000601:surgery; D059549:Anterior Cruciate Ligament Reconstruction / Q000009:adverse effects* / Q000379:methods; D001182:Arthroscopy; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D012307:Risk Factors; D013710:Tendons / Q000637:transplantation; D014184:Transplantation, Homologous; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*